Venous Access for Cancer
What is Venous Access?
For many treatments it is necessary to have access to a vein to deliver medication, blood products or nutrition. For short term treatment while in hospital this may simply require a cannula in an arm vein like that used to administer an intravenous fluid drip.
When longer term access is required, e.g. for more prolonged courses of antibiotics, chemotherapy, dialysis or ongoing nutrition (total parenteral nutrition or TPN) it may be necessary to place a central venous line or port to deliver medication directly into one of the larger central veins. A wide range of venous access systems is available including:
- Peripherally inserted central catheter or PICC line
- Tunnelled central venous lines, e.g. Hickman line
- Implanted Portacath
What type of Venous Access is recommended?
The exact type of line or port recommended will depend on what it is being used for and for how long it will be required. Dr. Crowe offers central venous access procedures to a wide group of colleagues in other specialities and will liaise with your specialist to facilitate whatever access is required. In many situations more than one option is possible and patient preferences are always taken into account.
For cancer patients requiring chemotherapy close co-operation between the various specialists and oncology nurses involved ensures that suitable venous access is planned in advance. A Portacath, tunnelled central line (e.g. a Hickman line) or PICC line can be arranged as a day case procedure under Dr. Crowe’s care before chemotherapy is due to start.
PICC Line
A PICC line is peripherally inserted central cannula. It is essentially a longer version of a standard cannula that is usually place in an upper arm vein above the elbow. It is placed under local anaesthetic and a combination of ultrasound and x-ray screening guidance so that the tip of the line can be accurately placed in a large vein close to the heart.
If you wish to find out more, please read the Patient Information booklet.
Tunnelled Central Venous Line
There are various types of tunnelled central venous lines, e.g. Hickman line, Leonard, Tesio and Groschong lines. The commonest is the Hickman line and this type of line is often just referred to as a Hickman line. It is suitable for longer durations of treatment than is the case for PICC lines and as the line is tunnelled under the skin of the chest wall it is a more robust form of venous access with less risk of dislodgement.
If you wish to find out more, please read the Patient Information booklet.
Portacath
Portacaths or ports, Vascuports, Powerports are one of the most commonly used forms of long-term venous access for chemotherapy in cancer patients. The port is implanted under the skin and connected to a line or cannula the tip of which (as with Hickman lines) lies in a large vein close to the heart. This ensures that when injected into the portacath the chemotherapy is delivered into a large vein where it gets diluted and does not cause the kind of irritation seen when chemotherapy is given in small veins in the arm. Because the port is implanted under the skin it is completely contained once the initial wound has healed meaning that no line is left protruding or dangling from the skin entry point. Thus a portacath cause less interference with clothing, activities and lifestyle and theoretically carries left risk of infection.
If you wish to find out more, please read the Patient Information booklet.
For more information or to make an appointment, please use the contact form or speak to Dr. Crowe’s secretary on 0121 448 1502.
Private Medical Insurance
Dr. Crowe is recognised by all the major private health insurance providers. To avail of your private insurance cover it is essential to contact your insurer in advance and obtain the necessary pre-authorisation for treatment. Dr. Crowe’s office can provide his provider number for the insurance company concerned as well as the procedure codes for the proposed treatment. Having this information before contacting your insurer speeds up the process of getting pre-authorisation.
While Dr. Crowe’s professional fees are within the insurance companies’ published guideline ranges the level of cover will depend on the conditions of your individual policy or that provided by your employer and cover should always be checked in advance. Some policies may stipulate an excess to be paid by the policy holder and this may be invoiced to you directly. There may be annual limits on cover, limits on out-patient cover or restricted cover for pre-existing conditions. Certain policies may also limit the choice of hospitals where treatment can be provided and this is particularly the case when considering treatment in central London. Insurers may stipulate that you must be referred to Dr. Crowe by your general practitioner or specialist but some allow self-referral or provide their own online GP service.
Self pay
It is not necessary to have private health insurance to avail of private medical care. More and more people are choosing to self-fund private treatment and are finding costs are often less than they had anticipated. Private medical care offers prompt and efficient diagnosis and treatment with your choice of consultant, at a time that suits you, in a clean and pleasant hospital environment.
Upon request price quotes can be obtained for the various treatments offered by Dr. Crowe. Having an initial consultation and scan does not commit you to proceeding with treatment and for more expensive high tech procedures the individual private hospitals can often offer a range of payment options. Although Dr. Crowe’s professional fees are standard regardless of treatment site the total costs are usually lower in Birmingham, reflecting higher hospital and clinic charges in central London.
For diagnostic scans Dr. Crowe can offer ultrasound, CT and MRI scanning at very reasonable self-fund rates that also vary from one private hospital to another. Plain X-Rays required for immigration and pre-employment health screening purposes can also be arranged.
Overseas Patients
Dr. Crowe is happy to take overseas referrals and can offer telephone and online consultations. Scans performed in your home country can be reviewed and he can liaise with your local doctors before you travel. Advice can be given on travel and follow up arrangements.
The private hospitals where Dr. Crowe practices can quote all in prices for treatment and assist with booking and arrangements prior to travel.
Dr. Crowe is recognised by many international and expatriate health insurance providers. In other cases the private hospitals may have agreements with international insurers and can facilitate treatment planning by liaising directly with the insurer for price quotes and invoicing.
Dr Crowe is based in London and Birmingham. Birmingham is the second largest city in the UK and is situated approximately 100 miles (160Km) north of London. There are excellent road and rail links and Birmingham International Airport provides direct flights to most European destinations as well as direct links to American, Asian and Middle Eastern cites.